| NPI | 1336690619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: AZ H01286) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NJ 22H100430000) |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2016-10-20 |