| NPI | 1144874108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: ND 2385) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: ND 2385) |
| 1223G0001X Dentist, General Practice (Licence: ND 2385) | |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2019-07-29 |