| NPI | 1720518160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TN 11850) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OK 6920) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2022-07-13 |