| NPI | 1790265858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MO 2017005949) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: IL 020015213) |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2018-08-17 |