| NPI | 1518318617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 5315228251) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.030863) |
| 1223G0001X Dentist, General Practice (Licence: MI 2901600886) | |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2022-02-16 |