| NPI | 1225606577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NC 11724) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: ND 11724) |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2021-06-14 |