| NPI | 1659985232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 107346) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00204298) |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2022-05-03 |