| NPI | 1336484351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MA DH10503) |
| Additional Taxonomies | 125K00000X Advanced Practice Dental Therapist (Licence: MA DH10503) |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2012-12-03 |