| NPI | 1962976092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: AZ H05418) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: H) |
| Enumeration Date | 2019-01-11 |
| Last Update Date | 2019-01-11 |