NPI | 1295097772 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 10304) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019029731) |
1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021002594) | |
Enumeration Date | 2012-06-12 |
Last Update Date | 2019-04-11 |