| NPI | 1699985119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 23692) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 21807) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2026-06-04 |