| NPI | 1275781791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 00203067) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CO 905700) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2022-07-21 |