| NPI | 1326411638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MI 2902013814) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: MI 2903002147) |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2015-11-09 |