| NPI | 1376038935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MO 2020023081) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IL 019031770) |
| 1223G0001X Dentist General Practice (Licence: FL 23482) | |
| 1223G0001X Dentist General Practice (Licence: CA 104916) | |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2024-06-20 |