| NPI | 1336617117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: IA RDH-03979) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MN H9766) |
| Enumeration Date | 2018-11-09 |
| Last Update Date | 2018-11-09 |