| NPI | 1851473425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 29246) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IA 08194) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: MN D12500) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2014-03-12 |