| NPI | 1699332619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 00204672) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401416897) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2024-04-24 |