| NPI | 1538612957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.030756) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 33619) |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2025-05-06 |