NPI | 1720699556 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 107161) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1858782) |
Enumeration Date | 2020-08-14 |
Last Update Date | 2022-03-11 |