| NPI | 1336329937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 24487) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 009659) |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2009-08-10 |