| NPI | 1396174439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019029680) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 7184-15) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2016-08-18 |