| NPI | 1104503721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NE 3200) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: NE 282) |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2023-07-05 |