| NPI | 1043547664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 7167-15) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 30032) |
| 122300000X Dentist (Licence: IL 019028141) | |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2025-07-11 |