| NPI | 1871833947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 31907) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 31907) |
| 122300000X Dentist (Licence: IL 019029556) | |
| 1223P0300X Dentist, Periodontics (Licence: IL 019029556) | |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2016-09-06 |