| NPI | 1184165516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN122544) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019031189) |
| 122300000X Dentist (Licence: TX 34965) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-18 |
| Last Update Date | 2022-03-01 |