NPI | 1578758140 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.028229) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN 18015) |
1223G0001X Dentist, General Practice (Licence: MI 2901019598) | |
Enumeration Date | 2007-09-07 |
Last Update Date | 2011-04-04 |