| NPI | 1407272966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO DEN205402) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 63297) |
| 1223G0001X Dentist, General Practice (Licence: CA 63297) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1857333) | |
| Enumeration Date | 2014-03-07 |
| Last Update Date | 2022-11-15 |