| NPI | 1104121375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 36682) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019028027) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2020-11-19 |