| NPI | 1194317560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 40096) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.032961) |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2023-11-02 |