| NPI | 1609955194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NM DD3611) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IL 19025429) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2019-06-28 |