| NPI | 1801515564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 17640) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00205287) |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2022-08-25 |