| NPI | 1528846235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NC 12552) |
| 124Q00000X Dental Hygienist (Licence: PA 072250) | |
| Enumeration Date | 2023-09-15 |
| Last Update Date | 2024-05-07 |