| NPI | 1174399901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NC 9602) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: SC 8579) |
| Enumeration Date | 2023-12-01 |
| Last Update Date | 2023-12-05 |