| NPI | 1063084465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN D14681) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.033236) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2022-01-13 |