| NPI | 1588952352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 6162) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 29210) |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2018-02-06 |