| NPI | 1962863902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 36656) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12012596A) |
| 122300000X Dentist (Licence: IL 019.030571) | |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2020-09-14 |