| NPI | 1992108013 |
|---|---|
| Other Name | N/A N/A |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 021.003060) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.032810) |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2022-11-16 |