| NPI | 1649403775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ D7818) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 32491) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2020-06-03 |