| NPI | 1891806253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 8142) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE61596831) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-08-07 |