| NPI | 1518703123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: AR 4772) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: AR 4772) |
| 1223P0300X Dentist Periodontics (Licence: AR 4772) | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: AR 4772) | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: AR 4772) | |
| Enumeration Date | 2024-07-02 |
| Last Update Date | 2024-07-02 |