| NPI | 1851706469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN.00202517) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 30154) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2017-04-04 |