| NPI | 1659930360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901601579) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.032121) |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2023-04-04 |