NPI | 1114156478 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 24550) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 6915) |
Enumeration Date | 2009-07-08 |
Last Update Date | 2019-06-11 |