| NPI | 1073289864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 108702) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.033386) |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2023-06-07 |