| NPI | 1093153033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN00202370) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 28900) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2014-10-23 |