| NPI | 1689939878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 28669) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12011853A) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2020-04-18 |