| NPI | 1629791892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MI 2902006905) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MI 20209100713) |
| Enumeration Date | 2022-09-22 |
| Last Update Date | 2022-09-22 |