| NPI | 1851964175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TX 37539) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: AZ D012083) |
| Enumeration Date | 2021-07-23 |
| Last Update Date | 2024-04-23 |