| NPI | 1679102578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CO 2025732) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: TN 9717) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2020-04-03 |