| NPI | 1245649649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 100123915) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019029755) |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2016-03-16 |