NPI | 1245406420 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 24504) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY P57060) |
Enumeration Date | 2008-05-07 |
Last Update Date | 2011-07-27 |