| NPI | 1174837751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: KS 11287) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MO 2010022535) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2010-08-05 |