| NPI | 1699451146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.035866) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: SC 10870) |
| 1223G0001X Dentist General Practice (Licence: IL 019.035866) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2025-07-08 |