| NPI | 1922367259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H7399) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: OR 118980) |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2017-05-04 |