| NPI | 1902239072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 32835) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 62755) |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2022-07-21 |