| 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 |