| NPI | 1689822157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: PR 2727) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: LA 5865) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2016-08-04 |