| NPI | 1962716340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H5961) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WI 10814-16) |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2012-11-19 |