| NPI | 1700907987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE00010942) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019026748) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2008-01-11 |