NPI | 1538549951 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 40786) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DTP720) |
1223P0221X Dentist, Pediatric Dentistry (Licence: NY 060171) | |
Enumeration Date | 2015-06-01 |
Last Update Date | 2024-08-01 |