| NPI | 1740803741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D010955) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12013345A) |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2021-02-10 |