| NPI | 1285287409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO DEN.00204650) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN R749) |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2024-01-15 |