| NPI | 1952656043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 00201803) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 00201803) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2022-07-21 |