| NPI | 1396795381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 25187) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 015946) |
| 1223G0001X Dentist, General Practice (Licence: AZ 5170) | |
| 1223G0001X Dentist, General Practice (Licence: IL 019-26330) | |
| 1223G0001X Dentist, General Practice (Licence: NE 6787) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2010-07-29 |