| NPI | 1417382011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO DEN.00202077) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NM DD3883) |
| 1223G0001X Dentist General Practice (Licence: KS 61451) | |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2019-06-13 |