| NPI | 1326048331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA DN1856442) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019020324) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PR 1768) | |
| Enumeration Date | 2005-08-01 |
| Last Update Date | 2019-05-02 |