| NPI | 1548519341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00204232) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901020813) |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2020-08-04 |