| NPI | 1972959740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO D.E.N.00205095) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 9799) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: KY 1044) | |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2023-02-13 |