| NPI | 1972037331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 33819) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 33819) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2023-09-25 |