| NPI | 1821667635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00205742) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D14711) |
| 1223G0001X Dentist, General Practice (Licence: WI 6001706-15) | |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2025-01-10 |