| NPI | 1780205211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: VA 0402207930) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MD 8133) |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2020-05-06 |