| NPI | 1366651887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H3114) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WA HL00007793) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2007-07-08 |