NPI | 1740390285 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 61988) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019-025964) |
1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021-002145) | |
Enumeration Date | 2006-08-30 |
Last Update Date | 2021-12-13 |