| NPI | 1104235159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 10726) |
| Additional Taxonomies | 122300000X Dentist (Licence: UT 9089502-9921) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2026-07-30 |