| NPI | 1265314512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2025029834) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019036153) |
| Enumeration Date | 2025-07-25 |
| Last Update Date | 2025-08-25 |