| NPI | 1295929289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H5155) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CA 22881) |
| Enumeration Date | 2007-09-01 |
| Last Update Date | 2007-09-01 |