| NPI | 1265735765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: VA 0402203843) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MS 2833-95DH) |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2010-12-06 |