| NPI | 1205080843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H4846) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WA IL 60127826) |
| 247200000X Technician, Other (Licence: OR COS-FT-10125043) | |
| 124Q00000X Dental Hygienist (Licence: CA RDH22343) | |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2011-01-26 |