| NPI | 1790986636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 9363) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12010972A) |
| 1223G0001X Dentist, General Practice (Licence: IL 019.027414) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2013-11-18 |