| NPI | 1720279490 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 22306) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 22306) | 
| 1223G0001X Dentist, General Practice (Licence: CO DEN-9505) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 22306) | |
| Enumeration Date | 2007-08-07 | 
| Last Update Date | 2023-06-20 |