| NPI | 1962073841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.034636) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 062645) |
| Enumeration Date | 2021-07-01 |
| Last Update Date | 2025-12-30 |