| NPI | 1902219652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 8382) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC DGD 8382) |
| 122300000X Dentist (Licence: IL 019.030440) | |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2023-09-22 |