| NPI | 1609100478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: AZ 6760) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: OR 5647) |
| Enumeration Date | 2009-09-28 |
| Last Update Date | 2010-03-11 |