| NPI | 1982040945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MD 6864) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: DC HYG1000701) |
| 124Q00000X Dental Hygienist (Licence: NC 8823) | |
| 124Q00000X Dental Hygienist (Licence: VA 0402205485) | |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2013-05-24 |