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 |