| NPI | 1629427596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: TN 0000004921) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: TN 4921) |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2022-06-10 |