| NPI | 1053690552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WI 6706-16) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: IL 020.007667) |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2016-10-31 |