| NPI | 1548564180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN014835) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.028565) |
| Enumeration Date | 2010-12-22 |
| Last Update Date | 2018-03-01 |