| NPI | 1730616897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 10474) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 9924) |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2021-02-17 |