| NPI | 1215380282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: SC 3146) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NC 9971) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |