| NPI | 1497106884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 36297) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12012494A) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2022-09-08 |