| NPI | 1396411179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 11678) |
| Additional Taxonomies | 261QS1000X Clinic/Center Student Health |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2021-08-20 |