| NPI | 1710115894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 24989) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 053876) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2012-10-18 |