| NPI | 1154497493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 23750) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30-022333) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2023-03-10 |