| NPI | 1205278892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H6478) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: OH DH61023) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2013-07-23 |