| NPI | 1366690984 |
|---|---|
| Former Name | GISELA MARIA VELASQUEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TX 24293) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2023-05-02 |