| NPI | 1992026629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 31852) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.028312) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2016-08-24 |