| NPI | 1265952188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 9947) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019031405) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2022-07-29 |