| 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 |