NPI | 1730410051 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 58525) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 58525) |
Enumeration Date | 2010-01-26 |
Last Update Date | 2017-10-26 |