| NPI | 1063185445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WA DH60241153) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: ID DH-2441) |
| Enumeration Date | 2021-07-30 |
| Last Update Date | 2021-07-30 |