| NPI | 1073742086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 28530) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY P57972) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 054560) | |
| Enumeration Date | 2009-07-11 |
| Last Update Date | 2014-04-14 |