| NPI | 1023627015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 12744) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE61078397) |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2025-04-15 |