| NPI | 1811421720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: FL DH23934) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CO DH002024605) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2017-04-18 |