| NPI | 1124834288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: PA RFD000075) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: IL 019.035633) |
| Enumeration Date | 2024-12-04 |
| Last Update Date | 2025-08-22 |