| NPI | 1386093946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MD 7740) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: TX 17321) |
| 124Q00000X Dental Hygienist (Licence: KY 4121) | |
| Enumeration Date | 2016-06-05 |
| Last Update Date | 2022-10-04 |