| NPI | 1679728208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 28713) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 055131) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1855840) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2018-03-17 |