| NPI | 1598146425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TN 10073) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN 10073) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2019-06-20 |