| NPI | 1831452440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 28751) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN D13126) |
| 122300000X Dentist (Licence: TX 28751) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: MN D13126) | |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2020-09-13 |