| NPI | 1619127461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 31564) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.027801) |
| 1223G0001X Dentist, General Practice (Licence: TN DS0000011076) | |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2021-02-11 |