| NPI | 1619485554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: TX 21363) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: TX 37325) |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2018-03-17 |