| NPI | 1992319107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 205093) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WY 1556) |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2023-07-12 |