NPI | 1659526143 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MI 2902008683) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: VA 0402204109) |
Enumeration Date | 2008-11-25 |
Last Update Date | 2017-01-25 |