| NPI | 1073139283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS113751) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00204414) |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2026-08-28 |