NPI | 1790370617 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00205004) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2021-03-03 |
Last Update Date | 2022-08-23 |