| NPI | 1891328837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: IL 021.003210) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 10355) |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2023-12-20 |