| NPI | 1356072433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO DEN.00206133) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 27018) |
| 1223G0001X Dentist, General Practice (Licence: CO 00206133) | |
| Enumeration Date | 2022-06-21 |
| Last Update Date | 2026-02-27 |