NPI | 1588762520 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: VA 0402004748) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MD 4592) |
Enumeration Date | 2006-09-21 |
Last Update Date | 2013-08-15 |