| NPI | 1689296154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: TX 12789) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CO DH.002025133) |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2023-04-27 |