| NPI | 1861930059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 11195) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 0598331) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2022-04-14 |