| NPI | 1699820837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 30852) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.025452) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2016-10-07 |