| NPI | 1033845524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 063098) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.032881) |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2023-06-26 |