| NPI | 1174044390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 9992) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12012801A) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2019-10-14 |