| NPI | 1235878638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZA2600X Specialist/Technologist, Other, Art, Medical (Licence: TX 1006437) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: TX 3329) |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2022-06-07 |