| NPI | 1003007352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12011066A) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MA 21957) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2010-03-12 |