| NPI | 1174827307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NE 1252) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NE 51) |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2011-01-03 |