| NPI | 1912345042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN24377) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019029445) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2021-08-27 |