| NPI | 1558510412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 34845) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE60035929) |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2024-06-28 |