NPI | 1477122919 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.034239) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019.034239) |
1223G0001X Dentist, General Practice (Licence: MI 2901600908) | |
Enumeration Date | 2021-06-19 |
Last Update Date | 2023-08-23 |