| NPI | 1023362175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: FL DH4047) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CO 201322) |
| Enumeration Date | 2012-10-27 |
| Last Update Date | 2012-10-27 |