| NPI | 1033501457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CO 1038) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MI 2902002429) |
| Enumeration Date | 2015-02-22 |
| Last Update Date | 2015-02-22 |