| NPI | 1922418169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: KY 9476) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 9476) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12012676A) | |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2017-05-31 |