| NPI | 1124257936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO DEN.00203199) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401412728) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2018-03-17 |