| NPI | 1720645971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.032392) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30.025723) |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2019-10-24 |