| NPI | 1528506425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: FL DH16444) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: SC 9477) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2017-02-10 |