| NPI | 1093195125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H6684) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NY 027128) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2015-06-03 |