| NPI | 1881949592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TX 31773) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.029137) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2021-06-09 |