| NPI | 1336585496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ID 1171147) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00203790) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2025-05-27 |