| NPI | 1790842003 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12010928A) | 
| Additional Taxonomies | 122300000X Dentist (Licence: IL 19026963) | 
| Enumeration Date | 2007-01-03 | 
| Last Update Date | 2011-06-20 |