| NPI | 1396372777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN D15163) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.032653) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2026-03-11 |