| NPI | 1992907059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 20584) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 55507) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2019-09-26 |