| NPI | 1861403982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE10039) |
| Additional Taxonomies | 122300000X Dentist (Licence: HI DT-2151) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2021-11-03 |