| NPI | 1952976409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 12437) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 1223G0001X Dentist, General Practice (Licence: VA 0401418356) | |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2024-07-02 |