| NPI | 1225015126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS036634) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN DS0000006900) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2022-10-10 |