| NPI | 1548707128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD4685) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 00203056) |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2023-07-17 |