| NPI | 1841585270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 61214) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12011665A) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2017-02-15 |