| NPI | 1356640866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NY 023991-1) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NC 9673) |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2011-03-23 |