| NPI | 1083937387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 25265) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 10197) |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2021-09-01 |