| NPI | 1861955569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN.00206109) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D010503) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2024-09-08 |