| NPI | 1174288153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019.034684) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2021044569) |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2024-07-16 |