| NPI | 1235372947 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.027874)  | 
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS 037307)  | 
| Enumeration Date | 2009-04-10 | 
| Last Update Date | 2009-04-10 |