| NPI | 1821344508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0004X Dentist Dentist Anesthesiologist (Licence: CO 00201811) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 00201811) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2022-07-21 |