| NPI | 1669917449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.032434) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS041086) |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2019-11-21 |