| NPI | 1073131348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 1002420-15) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.032759) |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2020-10-04 |