| NPI | 1760646509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MS 3468-08) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MS 3468-08) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2019-06-25 |