| NPI | 1063148633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MI 2901601565) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: IL 019.033755) |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2023-01-19 |