| NPI | 1972170405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 39453) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.033262) |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2024-01-30 |