NPI | 1861014672 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS106103) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH RES.004191) |
Enumeration Date | 2020-05-14 |
Last Update Date | 2021-09-16 |