| NPI | 1205190766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NE 2106) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: IA 03710) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2012-06-29 |