| NPI | 1720287998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CO 9476) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019026466) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2014-11-04 |