| NPI | 1063030856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 38674) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.032656) |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2022-08-15 |