| NPI | 1710386115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MO 8) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MO 2009017104) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-08-21 |