| NPI | 1770818585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CO 905647) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: UT 7085689-9920) |
| Enumeration Date | 2009-10-12 |
| Last Update Date | 2009-10-12 |