| NPI | 1912578246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 22259140927) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.033255) |
| Enumeration Date | 2021-07-07 |
| Last Update Date | 2025-06-16 |