| NPI | 1417478462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: KS 12236) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MO 2017019402) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2018-03-17 |