| NPI | 1699189498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 204815) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 30039) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2022-11-02 |