| NPI | 1043570575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H5188) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WA HL00007981) |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2022-01-04 |