| NPI | 1790916047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 018001742) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.028224) |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2010-04-12 |