| NPI | 1336408749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 28814) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: AL 6279) |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2017-02-10 |