| NPI | 1790122620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019029387) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12012246A) |
| Enumeration Date | 2013-06-01 |
| Last Update Date | 2015-07-13 |