| NPI | 1013234145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN DS0000009459) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN DS0000009459) |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2014-07-25 |