| NPI | 1619217528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: FL DH15942) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9288870) |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2013-03-01 |