| NPI | 1144347600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2012019292) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019026147) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2015-04-28 |