| NPI | 1356485650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NM DD5555) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IL 019-025820) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2021-12-23 |