| NPI | 1902157100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 39762) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS039360) |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2023-07-13 |