| NPI | 1760503650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 50 051926) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.028932) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2012-10-08 |