| NPI | 1255462958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN013837) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019027225) |
| 122300000X Dentist (Licence: CT 009850) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2013-06-18 |