| NPI | 1083064901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 12138) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN015195) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2023-06-27 |