| NPI | 1407134455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2011020304) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.028729) |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2011-08-05 |