| NPI | 1003476771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.032177) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12013228A) |
| Enumeration Date | 2019-06-16 |
| Last Update Date | 2021-01-15 |