| NPI | 1366168932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 124Q00000X Dental Hygienist |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2022-10-17 |