| NPI | 1730807439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 40138) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 107797) |
| 122300000X Dentist (Licence: TX 40138) | |
| Enumeration Date | 2022-08-18 |
| Last Update Date | 2025-07-27 |