| NPI | 1629426119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: GA DH011288) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: VA 0402203270) |
| 124Q00000X Dental Hygienist (Licence: PA DH009142L) | |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2016-05-25 |