| NPI | 1417395682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN 10609) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 30840) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2022-08-12 |