| NPI | 1043585706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DTP568) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 136-000255) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2020-07-30 |