| NPI | 1831645050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H7172) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: AZ H8017) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-08-28 |