NPI | 1255715041 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.031053) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN 21430) |
Enumeration Date | 2015-07-12 |
Last Update Date | 2019-06-04 |