| NPI | 1629813688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: FL DN25100) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019035024) |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TX 40742) | |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2024-07-01 |