| NPI | 1629194535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D009694) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 19027057) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-06-05 |