| NPI | 1861861197 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 122300000X Dentist (Licence: HI DT-2671)  | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO DEN.00202575)  | 
| Enumeration Date | 2015-09-16 | 
| Last Update Date | 2016-09-26 |