| NPI | 1649897109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00205822) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS042701) |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2025-05-01 |