| NPI | 1346658408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 40941) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 21117) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: FL 21117) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2024-10-29 |