| NPI | 1336696160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401418856) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00203136) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2024-07-13 |