| NPI | 1043532674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 34456) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 59109) |
| Enumeration Date | 2010-02-23 |
| Last Update Date | 2019-08-12 |