| NPI | 1194369801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D11327) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019032426) |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2020-10-06 |