| NPI | 1578652475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: AZ 2596) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: OH DH-8961) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2008-03-11 |