| NPI | 1164156311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 11976) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: TN 11976) |
| Enumeration Date | 2022-07-13 |
| Last Update Date | 2022-11-28 |