| NPI | 1134884406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: LA 2762) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 2762) |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2021-11-02 |