| NPI | 1194399170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: VT 015.0001559) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: VT 0015.0001559) |
| Enumeration Date | 2021-05-14 |
| Last Update Date | 2021-05-14 |