| NPI | 1962889170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OK 3746) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: OK 1077) |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2015-04-27 |