| NPI | 1821334871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: VA 0402203361) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: FL DH16943) |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2012-12-19 |