| NPI | 1609024074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1857130) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 018001708) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2018-03-14 |