| NPI | 1295347326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00205760) |
| Additional Taxonomies | 122300000X Dentist (Licence: NM DD5309) |
| 122300000X Dentist (Licence: TX 37694) | |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2025-06-11 |