| NPI | 1831305762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: WA DE00010726) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 19027202) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2013-01-15 |