| NPI | 1578828091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 29129) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 61062) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2013-11-14 |