| NPI | 1417164393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MA 12747) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: GA DH010003) |
| 124Q00000X Dental Hygienist (Licence: KY 3488) | |
| 124Q00000X Dental Hygienist (Licence: SC 4118) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-07-08 |