| NPI | 1972768935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019-022298) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: IL 019022298) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 019022298) | |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2014-06-24 |