NPI | 1760568828 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 39107) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: CA 39107) |
Enumeration Date | 2006-10-31 |
Last Update Date | 2007-07-08 |