| NPI | 1801298682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MO 2010040435) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: IL 020.013509) |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2014-09-23 |