| NPI | 1376010777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MO 2017044311) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: KS 12451) |
| Enumeration Date | 2018-10-24 |
| Last Update Date | 2018-10-24 |