| NPI | 1306076369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 28841) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 5995) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2016-10-25 |