| NPI | 1639772700 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS106181) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019032909) | 
| Enumeration Date | 2020-11-19 | 
| Last Update Date | 2021-09-08 |