| NPI | 1669251021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MD 7468) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: FL DH25876) |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2023-09-25 |