| NPI | 1013783372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 0000012357) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA 61455535) |
| Enumeration Date | 2023-11-28 |
| Last Update Date | 2023-11-28 |