| NPI | 1093207219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021.003151) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.025403) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2023-07-28 |