| 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 |