| NPI | 1881029668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NM DD5029) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 62641) |
| 1223G0001X Dentist General Practice (Licence: CO DEN00202360) | |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2023-01-04 |