| 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 |