| NPI | 1225470206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 29859) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DC DEN1001270) |
| 1223G0001X Dentist, General Practice (Licence: MD 15451) | |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2018-05-10 |