| NPI | 1811290513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: KY 3817) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: OR H5779) |
| Enumeration Date | 2010-12-19 |
| Last Update Date | 2010-12-19 |