| NPI | 1790399582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: DE G2-0003036) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: OH 31.016204) |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2020-10-15 |