NPI | 1588963789 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021002555) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2011007163) |
Enumeration Date | 2011-03-28 |
Last Update Date | 2018-03-17 |