NPI | 1972745313 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 25711) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 54917) |
Enumeration Date | 2009-03-31 |
Last Update Date | 2012-02-02 |