| NPI | 1619380953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 30864) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ D010976) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2023-07-25 |