| NPI | 1275814212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 27427) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 59728) |
| 1223G0001X Dentist, General Practice (Licence: TX 27427) | |
| Enumeration Date | 2011-09-05 |
| Last Update Date | 2011-09-26 |