| NPI | 1780947879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00202521) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL Dn19793) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2015-12-22 |