| NPI | 1629104740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 27193) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 14044) |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2016-05-10 |