| NPI | 1245788777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: VA 0401416033) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12012490A) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2020-06-02 |