| NPI | 1740430420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 0193854900) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: IL 0193854900) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: IL 0193854900) | |
| 1223P0300X Dentist Periodontics (Licence: IL 0193854900) | |
| 1223P0700X Dentist Prosthodontics (Licence: IL 0193854900) | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: IL 0193584900) | |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2008-09-30 |