| NPI | 1871146076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019.032255) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: OH 30.025920) |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-09-25 |