| NPI | 1548607120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MS 3686-13) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN DS0000009511) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2013-05-23 |