| NPI | 1073884060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: HI DH-1566) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: TX 0013731) |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2012-01-23 |