NPI | 1902418726 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CO 00204501) |
Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00204501) |
Enumeration Date | 2020-08-21 |
Last Update Date | 2023-04-01 |