| NPI | 1508561317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401419084) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: FL DH26428) |
| 124Q00000X Dental Hygienist (Licence: DC HYG1001025) | |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2024-08-15 |