| NPI | 1659850691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 34596) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019030367) |
| Enumeration Date | 2018-08-10 |
| Last Update Date | 2021-07-21 |