| NPI | 1104901388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00202484) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 5109) |
| 122300000X Dentist (Licence: CA 54734) | |
| 122300000X Dentist (Licence: NY 053350) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2022-03-31 |