| NPI | 1770855090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H5719) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WA DH60113542) |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2013-01-29 |