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 | 2024-07-16 |