| NPI | 1023509205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WA DH60263001) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: ID DH-1722-RST) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-05-23 |