| NPI | 1861946097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1858202) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN DS0000010316) |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2019-05-18 |