| NPI | 1083029086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN 10976) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AL 6110) |
| 122300000X Dentist (Licence: AL 6110) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 33891) | |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2019-07-28 |