| NPI | 1407300213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NM 4260) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: AZ 7124) |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2016-08-09 |