| NPI | 1316551120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 11373) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 10519) |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2023-03-17 |