| NPI | 1265642045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OH 3388) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: TX 4404) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2007-07-08 |