| NPI | 1770712143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 055757-1) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019027999) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2015-01-27 |