| 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 |