| NPI | 1467168666 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 41857) | 
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 109022) | 
| Enumeration Date | 2023-01-31 | 
| Last Update Date | 2025-08-15 |