| NPI | 1003177494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 10419) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN014710) |
| Enumeration Date | 2012-06-02 |
| Last Update Date | 2020-06-12 |