NPI | 1831596857 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 64352) |
Additional Taxonomies | 122300000X Dentist (Licence: WA DE60482837) |
Enumeration Date | 2014-11-20 |
Last Update Date | 2015-10-23 |