| NPI | 1295971943 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN26556)  | 
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019 022595)  | 
| Enumeration Date | 2008-12-31 | 
| Last Update Date | 2023-03-06 |