| NPI | 1356833602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MS 4295-22) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN 10762) |
| 1223G0001X Dentist, General Practice (Licence: TN 10762) | |
| Enumeration Date | 2018-06-02 |
| Last Update Date | 2022-06-13 |