| NPI | 1215649694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 12415) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 10960) |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2024-02-08 |