| NPI | 1023793551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO DEN00205805) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MI 2901601724) |
| Enumeration Date | 2023-06-21 |
| Last Update Date | 2024-02-23 |