| NPI | 1376711580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 10114) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 8781) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2022-04-06 |