NPI | 1730777699 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 107460) |
Additional Taxonomies | 122300000X Dentist (Licence: WA DE61167850) |
1223G0001X Dentist, General Practice (Licence: TX 36644) | |
Enumeration Date | 2021-01-06 |
Last Update Date | 2024-11-05 |