NPI | 1750793360 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 63108) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 63108) |
Enumeration Date | 2014-05-30 |
Last Update Date | 2023-11-07 |