| NPI | 1578146908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1859084) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.031853) |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2022-03-01 |