| NPI | 1629365192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AR 3872) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TN 9289) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2017-03-08 |