| NPI | 1609328723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 11510) |
| Additional Taxonomies | 122300000X Dentist (Licence: MS 4176-20) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2021-09-26 |