| NPI | 1730457219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MO 2011017977) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: KS 11364) |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2011-12-12 |