| NPI | 1366936304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 125J00000X Dental Therapist (Licence: AK 18146DHAT) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: AK 18146PDHAII) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2022-04-20 |