| NPI | 1831800804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: MD 7045) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MD 7045) |
| Enumeration Date | 2022-12-09 |
| Last Update Date | 2022-12-09 |