| NPI | 1497848030 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 25204) | 
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30022239) | 
| Enumeration Date | 2006-10-02 | 
| Last Update Date | 2021-02-18 |