| NPI | 1114020492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WI 5604-016) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: SC 2555) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2007-07-08 |