| NPI | 1063965614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019030912) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2017012882) |
| 122300000X Dentist (Licence: MA DN1859245) | |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2024-06-21 |