| NPI | 1356567390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO DEN.00202130) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: KY 7200) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2022-03-07 |