| NPI | 1275094914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: PR 3340) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1859124) |
| 122300000X Dentist (Licence: PR 3340) | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2024-10-09 |