| NPI | 1295324325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD5505) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00204620) |
| 122300000X Dentist (Licence: NM DD5505) | |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2025-03-19 |