| NPI | 1720845019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MD 7539) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: MD 219670) |
| Enumeration Date | 2024-03-04 |
| Last Update Date | 2024-03-04 |