| NPI | 1013528801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA RES-30634) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.032836) |
| 1223G0001X Dentist, General Practice (Licence: TX 37624) | |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2023-01-03 |