| NPI | 1023319571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 34492) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 14558) |
| Enumeration Date | 2010-11-14 |
| Last Update Date | 2023-03-30 |