| NPI | 1528760394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 00205502) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00205502) |
| 122300000X Dentist (Licence: CO 00205502) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-03-17 |
| Last Update Date | 2023-06-14 |