| NPI | 1720473911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO DEN.00204185) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC AC5385578-R1112) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2021-01-20 |