NPI | 1043906159 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WI 7001101-16) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MN H11462) |
Enumeration Date | 2023-04-12 |
Last Update Date | 2023-04-12 |