| NPI | 1124478599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MN H8434) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: AK DENH2237) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2016-06-16 |