| NPI | 1831789742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO DEN.00204845) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA DDS104754) |
| Enumeration Date | 2021-01-25 |
| Last Update Date | 2021-08-16 |