| NPI | 1154934446 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 38990) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12013476A) | 
| 1223G0001X Dentist, General Practice (Licence: TX 38990) | |
| Enumeration Date | 2020-08-26 | 
| Last Update Date | 2022-11-30 |