| NPI | 1134209786 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 122300000X Dentist (Licence: NY 057201-1) | 
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019-022924) | 
| Enumeration Date | 2006-10-17 | 
| Last Update Date | 2018-07-14 |