| NPI | 1992109235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WA IL60356985) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MI 2902014930) |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2014-10-15 |