| NPI | 1770575888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 56859) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 20568) |
| 122300000X Dentist (Licence: IL 019027560) | |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2016-03-09 |