| NPI | 1477194561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 2952000342) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019033021) |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2025-03-25 |