| NPI | 1174949101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: DC 1002093) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 31637) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2020-07-28 |