| 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 |