| NPI | 1245760040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901022630) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.031329) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2019-02-25 |