| NPI | 1003492513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MN D14863) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IL 019.033464) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2023-06-02 |