| NPI | 1811696172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.036498) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 39696) |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2025-12-19 |