| NPI | 1235915521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WI 177798-30) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WI 9735-16) |
| Enumeration Date | 2023-09-04 |
| Last Update Date | 2023-09-04 |