| NPI | 1205045796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: UT 5655443-0701) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: TX 13208) |
| 124Q00000X Dental Hygienist (Licence: AZ 5908) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2007-07-08 |