| NPI | 1902028285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: CO 9280) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: CO 00009280) |
| 122300000X Dentist (Licence: CO 00009280) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2023-06-30 |