| NPI | 1962866129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NV 3160) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CA 20513) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2016-04-13 |