| NPI | 1780690644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 18902) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019022407) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2007-07-08 |