| NPI | 1124834544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 6001624) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.035424) |
| Enumeration Date | 2024-12-10 |
| Last Update Date | 2024-12-10 |