| 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 |