| NPI | 1306382346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NY 018893) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NJ 22H100568100) |
| Enumeration Date | 2017-01-15 |
| Last Update Date | 2017-01-15 |