| NPI | 1326663279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00205736) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 004224) |
| 122300000X Dentist (Licence: NY 061812) | |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2023-09-07 |