NPI | 1811106735 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CO 00205044) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 44354) |
Enumeration Date | 2007-05-21 |
Last Update Date | 2024-05-30 |