| NPI | 1831828268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 40404) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00205138) |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2024-06-03 |