| NPI | 1760768097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OK 4362) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CO 905522) |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2020-01-13 |