| NPI | 1043766603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: GA DH010304) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: FL DH17953) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2022-04-02 |