| NPI | 1174932271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2014018760) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN 9874) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2014-08-04 |