| NPI | 1417615352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MS 4081-19) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MS 4081-19) |
| Enumeration Date | 2021-12-07 |
| Last Update Date | 2021-12-07 |