| NPI | 1649556051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12013272A) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 30.023353) |
| Enumeration Date | 2011-10-30 |
| Last Update Date | 2020-02-10 |