| NPI | 1790014850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO DEN.00007703) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 7703) |
| Enumeration Date | 2009-12-18 |
| Last Update Date | 2018-11-20 |