| NPI | 1780040998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: IL 019032048) |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: MI 2901021739) |
| 1223P0700X Dentist Prosthodontics (Licence: MO 2019000967) | |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2023-03-29 |