| NPI | 1134407604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 28835) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901020469) |
| 1223G0001X Dentist General Practice (Licence: IL 019028831) | |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2024-03-26 |