| NPI | 1720494784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.030288) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL12224) |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2018-10-31 |