| NPI | 1891174793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12012664A) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS040338) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2021-01-11 |