| NPI | 1740808005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE61081766) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.032793) |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2021-09-02 |