| NPI | 1982761722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MD 4381) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WV 2001) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2007-07-08 |