| NPI | 1245863547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 126800000X Dental Assistant (Licence: AR 13461) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: AR 09489) |
| 261QC1500X Clinic/Center, Community Health | |
| 376K00000X Nurse's Aide (Licence: AR 0069104R) | |
| Enumeration Date | 2020-02-15 |
| Last Update Date | 2020-02-15 |