| NPI | 1649317702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 015867) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.024344) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2009-10-22 |