| NPI | 1538614086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA DDS-09328) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.033491) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2025-03-04 |