| NPI | 1083007744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MN D13530) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 6002286-15) |
| 1223G0001X Dentist, General Practice (Licence: IL 019.034271) | |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2026-08-14 |