| NPI | 1619289600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CA 61213) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: IL 018001760) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2021-03-04 |