| NPI | 1740620731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: ID D-5505-PD) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ID D-5505) |
| 1223G0001X Dentist, General Practice (Licence: WI 7130) | |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2024-05-13 |