| NPI | 1285939322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 32403) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IL 019028548) |
| Enumeration Date | 2011-01-21 |
| Last Update Date | 2016-12-08 |