| NPI | 1891007548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 26369) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 058189) |
| 1223G0001X Dentist, General Practice (Licence: TX 26369) | |
| Enumeration Date | 2010-07-10 |
| Last Update Date | 2020-05-10 |