| NPI | 1376808451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MS 4347-22) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: TX 29802) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2023-03-01 |