| NPI | 1902096720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 016112) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 319011093) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2017-05-02 |