| NPI | 1144514373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 34450) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 058158) |
| 1223G0001X Dentist, General Practice (Licence: GA DN014251) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2024-06-11 |