| NPI | 1942512900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 9155) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 9155) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2013-09-20 |