| NPI | 1316313778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 64777) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.030273) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |