| NPI | 1912357468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: SC 2844) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: GA DH005049) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2016-06-15 |