| NPI | 1598041121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: SC 5854) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: VA 0402205230) |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2023-10-28 |