| NPI | 1982199972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00204377) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001887) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2021-02-23 |