| NPI | 1962849117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12013421A) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1856253) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2020-10-28 |