| NPI | 1851545818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 22935) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 22935) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2012-04-06 |