| NPI | 1487886610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: LA 3585) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WV 2609) |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2009-08-21 |