| NPI | 1508209925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021.002687) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.029487) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: CO DEN.00204586) | |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2021-07-27 |