| NPI | 1548690688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MS OR-484-14) |
| Additional Taxonomies | 122300000X Dentist (Licence: MS 3651-12) |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2018-10-08 |