| NPI | 1245850411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021003212) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.033567) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2024-02-06 |