| NPI | 1447603410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 060161) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019030848) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2019-01-07 |