| NPI | 1699136036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 36787) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NH 04496) |
| Enumeration Date | 2016-03-13 |
| Last Update Date | 2024-03-10 |