NPI | 1861600124 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 58146) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN 17) |
1223G0001X Dentist, General Practice (Licence: CA 58146) | |
1223G0001X Dentist, General Practice (Licence: FL DN 17) | |
Enumeration Date | 2007-05-19 |
Last Update Date | 2017-08-21 |