| NPI | 1720105794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: AZ DH 5531) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NM DH 2826) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2019-08-16 |