| NPI | 1487830360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MN H6499) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: IA 02835) |
| 124Q00000X Dental Hygienist (Licence: SD 927) | |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2008-01-10 |