| NPI | 1609387810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CO DEN.00205974) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 102091) |
| 1223G0001X Dentist, General Practice (Licence: TX 35065) | |
| Enumeration Date | 2017-10-14 |
| Last Update Date | 2024-08-06 |