| NPI | 1619448677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 687) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: FL 687) |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2018-12-16 |