| NPI | 1255641981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H4264) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CA 14576) |
| 124Q00000X Dental Hygienist (Licence: NV 2333) | |
| 124Q00000X Dental Hygienist (Licence: ID DH-526) | |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2010-10-15 |