| NPI | 1386926400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 27412) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 27412) |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2019-09-26 |