NPI | 1164042198 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 019.032838) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021.003285) | |
Enumeration Date | 2020-04-20 |
Last Update Date | 2023-10-24 |