| NPI | 1831716752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 204869) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 36222) |
| 1223G0001X Dentist, General Practice (Licence: CO DEN.00204869) | |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2022-05-02 |