| NPI | 1972593960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 61111) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019-026460) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2026-01-22 |