| NPI | 1689057481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 00203574) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO DEN.00203574) |
| 1223G0001X Dentist, General Practice (Licence: IL 019.030201) | |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2023-04-10 |