| NPI | 1174963755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: HI DT2590) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL11902) |
| 122300000X Dentist (Licence: VT 016.0101814) | |
| 122300000X Dentist (Licence: RI DEN03355) | |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2021-07-15 |