| NPI | 1659523348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 33605) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 6416) |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2018-03-17 |