| NPI | 1720751282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00205791) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D011155) |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2024-05-07 |