| NPI | 1003018995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019018298) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 8537) |
| 1223P0700X Dentist, Prosthodontics (Licence: MO DS 00870) | |
| 122300000X Dentist (Licence: KY 8537) | |
| Enumeration Date | 2007-06-03 |
| Last Update Date | 2017-02-09 |