| NPI | 1003902032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 28694) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 5636) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2013-11-05 |