| NPI | 1710179023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MS 3980-18) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO DEN-9511) |
| 1223G0001X Dentist, General Practice (Licence: MS 3980-18) | |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2020-04-28 |