| NPI | 1831577105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: TX 14055) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: LA 4457) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2015-05-07 |