| NPI | 1902359136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 33544) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.030886) |
| Enumeration Date | 2016-07-23 |
| Last Update Date | 2018-12-11 |