| NPI | 1861708976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.028551) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2013014187) |
| 122300000X Dentist (Licence: AK 1305) | |
| 122300000X Dentist (Licence: MT 4044) | |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2014-06-05 |