| NPI | 1609037316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021002438) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019028314) |
| 122300000X Dentist (Licence: OH 30.022815) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 2015009835) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2019-06-21 |