| NPI | 1427620285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 00204819) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 12076) |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2023-08-25 |