| NPI | 1174262521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN122750) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA 00000000000000) |
| 122300000X Dentist (Licence: IL 019.033797) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2023-09-18 |