| NPI | 1033593009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 31236) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 0031236) |
| 1223G0001X Dentist, General Practice (Licence: MA DN1857330) | |
| Enumeration Date | 2015-07-19 |
| Last Update Date | 2022-05-23 |