| NPI | 1770713232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN.00201842) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN 9042) |
| Enumeration Date | 2009-07-19 |
| Last Update Date | 2013-07-24 |