| NPI | 1023703253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: TX 26252) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: TX 118990) |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2023-10-19 |