| NPI | 1528468444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 29933) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 29933) |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2026-07-06 |