| NPI | 1588393664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D11958) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00205143) |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2024-05-17 |