| NPI | 1700653250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: TX 18473) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: AK 128888) |
| Enumeration Date | 2023-12-05 |
| Last Update Date | 2023-12-05 |