| NPI | 1063797959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WI 5323-16) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MN H5621) |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2011-10-11 |