| NPI | 1467801258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN.00204355) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 1001347) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2021-04-07 |