| NPI | 1841425394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 25883) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS039982) |
| 1223G0001X Dentist, General Practice (Licence: TX 25883) | |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2018-03-17 |