| 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 |