| NPI | 1689368680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 109587) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00205575) |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2024-09-08 |