NPI | 1497221055 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MS OR-580-20) |
Additional Taxonomies | 122300000X Dentist (Licence: MS 3924-17) |
Enumeration Date | 2018-10-22 |
Last Update Date | 2020-10-07 |