NPI | 1679867824 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401414574) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019028647) |
Enumeration Date | 2011-06-06 |
Last Update Date | 2023-08-04 |