| NPI | 1912631623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00205285) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN27019) |
| 1223G0001X Dentist, General Practice (Licence: FL DN27019) | |
| Enumeration Date | 2022-07-11 |
| Last Update Date | 2023-08-04 |