| NPI | 1639732217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 10625) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO DEN.00204031) |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2021-08-16 |