| NPI | 1750518619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 8854) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12011321A) |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2012-09-11 |