| NPI | 1043308026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: AL 5033) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN 5385) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2014-01-31 |