| NPI | 1487213435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CO 00204660) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2019018442) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2021-08-09 |