| NPI | 1275756785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 9701) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12009606A) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2016-02-10 |