| NPI | 1073006359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.031827) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2018022632) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2020-08-11 |