| NPI | 1437205119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MT 1125) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WY 760) |
| 124Q00000X Dental Hygienist (Licence: MO 2004015668) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2007-07-08 |