| NPI | 1154745594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 29616) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 64432) |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2015-07-30 |