| NPI | 1194038125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CA 300) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CO 22521) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2010-07-19 |