| NPI | 1295512721 |
|---|---|
| Former Name | ELYSE MICHELLE KLOSTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 125K00000X Advanced Practice Dental Therapist (Licence: CA 1016) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CA 27213) |
| Enumeration Date | 2023-09-08 |
| Last Update Date | 2023-09-08 |