| NPI | 1598155376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 30992) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.029874) |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2015-08-18 |