| NPI | 1881841153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 26069) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 018.001612) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2010-11-30 |