| NPI | 1760896591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 2016008298) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12012189A) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2016-12-22 |