| NPI | 1578758140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019.028229) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: FL DN 18015) |
| 1223G0001X Dentist General Practice (Licence: MI 2901019598) | |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2011-04-04 |