| NPI | 1053968586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MO 2016025847) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: IL 020015623) |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2019-08-20 |