| NPI | 1760646566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NC 9264) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.027630) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2013-09-17 |