| NPI | 1447210083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TX 22651) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: AZ D6256) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: CA 61912) | |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2013-05-07 |