| NPI | 1396016986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MI 2902002714) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CO HD-903109) |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2012-01-13 |