| NPI | 1326425679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 1001464) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019030713) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2022-07-21 |