| NPI | 1649508656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 25101) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 14042917) |
| 122300000X Dentist (Licence: IL 019028576) | |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2022-10-26 |