| NPI | 1609461722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: KS 11562) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MO 2014000973) |
| Enumeration Date | 2021-03-02 |
| Last Update Date | 2021-03-02 |