| NPI | 1972164994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 11042) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AR 4415) |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2020-06-10 |