| NPI | 1316348451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2014016078) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.029773) |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2026-05-01 |