| NPI | 1417385030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WI 10621-016) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MN H8585) |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2013-10-16 |