| NPI | 1366960445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 203591) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12012821A) |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2022-10-14 |