| NPI | 1922588615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 00205025) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS102930) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2023-06-01 |