| NPI | 1063729457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CO DH00202347) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: AZ H6765) |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2014-09-10 |