| NPI | 1275141426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 105265) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.032801) |
| 122300000X Dentist (Licence: MN D14425) | |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2020-08-14 |