| NPI | 1356163216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: KS 12249) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MO 2016018876) |
| Enumeration Date | 2024-10-30 |
| Last Update Date | 2024-10-30 |