| NPI | 1639618325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MO 2012022466) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: MO 2016004424) |
| 126800000X Dental Assistant (Licence: MO 2016004425) | |
| 126800000X Dental Assistant (Licence: MO 2016004427) | |
| 126800000X Dental Assistant (Licence: MO 2016004422) | |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2017-02-15 |