| NPI | 1104678242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WI 10422-16) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WI 14966) |
| Enumeration Date | 2024-04-02 |
| Last Update Date | 2025-08-19 |