NPI | 1982883575 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CA 62346) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: PA DS0276299-L) |
Enumeration Date | 2007-10-31 |
Last Update Date | 2023-11-22 |