| NPI | 1013410901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019.030919) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: VA 0401415543) |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2018-03-16 |