NPI | 1811422421 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CA 103438) |
Additional Taxonomies | 122300000X Dentist (Licence: AZ D010163) |
Enumeration Date | 2017-04-21 |
Last Update Date | 2019-04-18 |