| NPI | 1467533695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0004X Dentist Dentist Anesthesiologist (Licence: AR 4419) |
| Additional Taxonomies | 122300000X Dentist (Licence: AR 4419) |
| 1223D0004X Dentist Dentist Anesthesiologist (Licence: TX 35015) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-06-16 |