| NPI | 1245617109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H6588) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: FL DH8490) |
| 124Q00000X Dental Hygienist (Licence: WA DH00005168) | |
| 124Q00000X Dental Hygienist (Licence: CO 2991) | |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2015-04-29 |