| NPI | 1508219403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.030973) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 100008) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2017-01-14 |