| NPI | 1902359136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 33544) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 33544) |
| 1223G0001X Dentist, General Practice (Licence: IL 019.030886) | |
| Enumeration Date | 2016-07-23 |
| Last Update Date | 2025-08-05 |