| NPI | 1104513134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: AR 4722) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2023022968) |
| Enumeration Date | 2023-04-19 |
| Last Update Date | 2024-04-04 |