| NPI | 1609865070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 23742) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019025741) |
| 122300000X Dentist (Licence: TX 23742) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 23742) | |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2011-07-22 |