| NPI | 1124450747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: AK 2026) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: OR H2280) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2013-08-06 |