| NPI | 1316229966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H5926) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MI 2902016102) |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2022-05-03 |