| NPI | 1942559596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H7006) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: OR 117669) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2018-05-15 |