| NPI | 1841638467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WI 375816) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: WI 2013254P) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2016-02-25 |