| NPI | 1528411055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 36042) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 100495) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2023-09-12 |