| NPI | 1700410248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: CO DEN.00204844) |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2022-04-08 |