| NPI | 1780242040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12013515) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 10302) |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2021-06-25 |