| NPI | 1295857654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 19024299) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 18411) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 21001885) | |
| Enumeration Date | 2007-04-05 |
| Last Update Date | 2007-07-08 |