| NPI | 1699173419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NE 1721) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: IA 3091) |
| Enumeration Date | 2014-12-10 |
| Last Update Date | 2014-12-10 |