| NPI | 1487123386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 39358) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DIO2738300) |
| Enumeration Date | 2018-11-20 |
| Last Update Date | 2024-01-01 |