| NPI | 1720334840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA 60578324) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019029136) |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2016-07-26 |