| NPI | 1871272864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 39898) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA DDS113146) |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2026-07-23 |