| NPI | 1053690255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021.002444) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.028773) |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2013-02-14 |