| NPI | 1144997727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TX ETN1027) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019033373) |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2023-06-09 |