| NPI | 1285760215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 3601) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 35897) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: GA 011786) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2021-01-14 |