| NPI | 1265728554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH OH 30.023707) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019028690) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2017-10-11 |