| NPI | 1770862609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WA DH60055001) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: OR H4361) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2022-03-09 |