| NPI | 1184392029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 107040) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IL 019032930) |
| Enumeration Date | 2021-09-04 |
| Last Update Date | 2024-07-16 |