| NPI | 1689112187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CO DEN.00203254) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS039513) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2025-08-29 |