| NPI | 1306903786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: WI 4828) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: IL 4828) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2014-03-04 |