| NPI | 1649567785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D10021) |
| Additional Taxonomies | 122300000X Dentist (Licence: HI DT2447) |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2015-04-28 |