| NPI | 1609030931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1855786) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019027759) |
| 1223G0001X Dentist, General Practice (Licence: CT 10734) | |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2012-07-11 |