NPI | 1972816353 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 105591) |
Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: VA 0401413888) |
Enumeration Date | 2010-07-14 |
Last Update Date | 2021-03-18 |