| NPI | 1619573870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: FL 22958) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: FL DH22958) |
| Enumeration Date | 2020-12-11 |
| Last Update Date | 2020-12-11 |