| NPI | 1841773405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H6859) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WA 60398824) |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2018-09-10 |