| NPI | 1407326523 | 
|---|---|
| Former Name | ADELA DIAZ | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: FL 18382)  | 
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: 18382)  | 
| Enumeration Date | 2018-12-01 | 
| Last Update Date | 2018-12-01 |