| NPI | 1952058091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: CO DEN.00205489) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2021035151) |
| Enumeration Date | 2022-03-08 |
| Last Update Date | 2023-07-18 |