| NPI | 1376169714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 105654) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00204486) |
| 122300000X Dentist (Licence: CO T-DEN.00000049) | |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2021-09-24 |