| NPI | 1760042840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO DEN.00204209) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IA DDS-09670) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2021-06-03 |