| NPI | 1457929754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 38131) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.033197) |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2022-03-01 |