| NPI | 1952538159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AR 4016) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO DEN-9923) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2015-12-30 |