| NPI | 1912095373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TX 20425) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 20425) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2023-05-02 |