| NPI | 1023320355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN DS9277) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 8920) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2012-08-08 |