| NPI | 1154553618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00205253) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.029696) |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2023-04-16 |