| NPI | 1316470032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: HI 2881) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 11282) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 11282) | |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2021-06-02 |