NPI | 1972915106 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN20051) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 62738) |
Enumeration Date | 2014-05-22 |
Last Update Date | 2018-06-17 |