| NPI | 1669987731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 33653) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO DEN.00203714) |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2020-02-28 |