| NPI | 1376647818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: IN 12011735A) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: KY 5104) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2012-06-19 |