| NPI | 1891176988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.031571) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1856963) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2018-08-07 |