| NPI | 1669929295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN24648) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.030748) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2024-01-15 |