| NPI | 1073073151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 1002251-15) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 319.021485) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2020-07-06 |