| NPI | 1447370622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: TX 13403) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: AR 1074) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2007-07-08 |