| NPI | 1598833139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 00204908) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019025847) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2022-10-09 |