| NPI | 1588103840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2017000649) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019030773) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-03-27 |