| NPI | 1083155816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VI 2435) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 6912) |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2021-04-28 |