| NPI | 1073095501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: ID DH-3679) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WA DH60888742) |
| Enumeration Date | 2018-08-31 |
| Last Update Date | 2021-03-31 |