| NPI | 1942577424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: VA 0402205511) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: GA 011269) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2011-11-28 |