| NPI | 1912265562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CO DEN.00202083) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: FL DN 20071) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2017-01-12 |