| NPI | 1740835529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MS OR-604-21) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AL D.0006692-C1) |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2021-09-24 |