| NPI | 1871933325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: FL DH18295) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: OH 31.011390) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2013-06-28 |