| NPI | 1154877611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12013723A) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 9583) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2022-11-02 |