| NPI | 1821705138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 108528) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.033989) |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2023-02-15 |