| NPI | 1295962421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: TX 8604) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NM 638) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2009-06-15 |