| NPI | 1003174657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN.00202012) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN 19835) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2021-10-15 |