| NPI | 1447963525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NC 12953) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: VA 0402208791) |
| Enumeration Date | 2023-01-03 |
| Last Update Date | 2023-01-03 |