| NPI | 1629764600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.036109) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 109670) |
| Enumeration Date | 2023-04-13 |
| Last Update Date | 2025-07-11 |