| NPI | 1659366813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 8119) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019024) |
| 1223G0001X Dentist, General Practice (Licence: NC 8119) | |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2024-03-25 |