| NPI | 1104821354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 8376) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 53161) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2011-03-23 |