| NPI | 1508892043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 16303) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 16303) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2024-05-07 |