| NPI | 1306523816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IA DDS-10136) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA DDS10136) |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2025-05-19 |