| NPI | 1578822607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NM DH 3281) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NM NDO0007) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2012-05-09 |