| NPI | 1649787300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H7496) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WA 60776317) |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2018-03-17 |