| NPI | 1982358537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: VA 0402004170) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NC 5200) |
| Enumeration Date | 2022-02-11 |
| Last Update Date | 2022-02-11 |