| NPI | 1053873331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IN 12013583A) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: OH 31.1694200) |
| 1223G0001X Dentist General Practice (Licence: OH 30.026090) | |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2021-08-02 |