| NPI | 1831360932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 58182) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.027557) |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2016-10-24 |