| NPI | 1457985004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: NC 12113) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 12113) |
| 1223G0001X Dentist, General Practice (Licence: CO DEN.00204329) | |
| Enumeration Date | 2020-02-22 |
| Last Update Date | 2021-10-06 |