| NPI | 1881197242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MI 2902009555) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NM DH2444) |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2018-03-13 |