| NPI | 1790946671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN-10037) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 14117) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2020-04-02 |