| NPI | 1952998312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: KS 12030) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MO 2015018809) |
| Enumeration Date | 2020-12-30 |
| Last Update Date | 2020-12-30 |