| NPI | 1457710568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN.00202756) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2016000785) |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-03-01 |