NPI | 1528673076 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 39220) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019032883) |
Enumeration Date | 2020-09-11 |
Last Update Date | 2023-08-09 |