| NPI | 1427451988 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NH 00760) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: ME 2809) |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2014-09-29 |