| NPI | 1992401970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: VA 0402208495) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MO 2020013074) |
| Enumeration Date | 2023-02-01 |
| Last Update Date | 2023-02-01 |