| NPI | 1477552776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN-10562) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 8162) |
| 1223G0001X Dentist, General Practice (Licence: OH 30-022267) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2016-06-15 |