| NPI | 1679234652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WA DH61207275) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: OR H7715) |
| Enumeration Date | 2022-01-03 |
| Last Update Date | 2022-01-03 |