| NPI | 1881145670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 32531) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 319.020340) |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2021-09-28 |