| NPI | 1225392541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60387777) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019028990) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2016-11-16 |