| NPI | 1699338202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN27531) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MS 4045-19) |
| 1223G0001X Dentist, General Practice (Licence: TN 11290) | |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2024-03-10 |