| NPI | 1043732753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 00205733) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 101550) |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2023-08-23 |