| NPI | 1629283403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 10946) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE00010512) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2023-09-28 |