| NPI | 1386102671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 019.033502) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 24704) |
| 1223G0001X Dentist, General Practice (Licence: SC 9563) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2022-07-14 |