| NPI | 1255486601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 100558) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IL 019026717) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2017-01-30 |