| NPI | 1346844271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MD 6079) |
| 124Q00000X Dental Hygienist (Licence: PA DH070430) | |
| Enumeration Date | 2020-11-22 |
| Last Update Date | 2021-09-22 |