| NPI | 1609208040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D10100) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019029604) |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2015-09-22 |