| NPI | 1609664986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: TX 26158) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: AZ H007454) |
| Enumeration Date | 2025-04-28 |
| Last Update Date | 2025-04-28 |