| NPI | 1649292103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DTP 648) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019025579) |
| 122300000X Dentist (Licence: MI 2901017322) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2016-11-02 |