| NPI | 1922791250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN.00205566) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.027148) |
| Enumeration Date | 2023-06-01 |
| Last Update Date | 2024-11-18 |