| NPI | 1770770646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019027183) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 6199-015) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2011-01-11 |