| NPI | 1306834684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010205) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 6846) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2007-07-08 |