| NPI | 1336580919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: AZ H4381) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: IL 020-004876) |
| 124Q00000X Dental Hygienist (Licence: WI 6743-016) | |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2013-07-11 |