NPI | 1356491138 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 16626) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019027587) |
Enumeration Date | 2007-01-12 |
Last Update Date | 2013-04-11 |