| NPI | 1609264191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 30275) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019030103) |
| 122300000X Dentist (Licence: TX 30275) | |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2022-02-28 |