| NPI | 1730609421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 38652) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 060873) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2022-06-29 |