| NPI | 1447619895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 102564) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00203104) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-02-14 |
| Last Update Date | 2019-04-28 |