| NPI | 1912380411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12013576A) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 10213) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2021-06-24 |