| NPI | 1316176316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CO 00201896) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 1223P0700X Dentist, Prosthodontics (Licence: CT 010407) | |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2020-10-26 |