| NPI | 1861740789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 9247) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901022542) |
| 122300000X Dentist (Licence: IN 12011856A) | |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2022-08-31 |