| NPI | 1265059828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 38237) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12013411A) |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2022-10-06 |