| NPI | 1558694729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 56790) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: IL 019027846) |
| Enumeration Date | 2009-09-04 |
| Last Update Date | 2012-04-25 |