| NPI | 1336547470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MA DH88119) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: RI DH02390) |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2014-12-05 |