| NPI | 1295245736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.026876) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.031425) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2024-09-05 |