| NPI | 1528633971 |
|---|---|
| Former Name | SAMANTHA EBERHARDT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: AZ H007412) |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2021-05-26 |